Archivos espanoles de urologia · 2026
Evidence-Based Pain Management and Rehabilitation Nursing is Associated With Reduced Early Postoperative Biochemical Stress Markers and Improved Recovery After Mini-PCNL for Complex Renal or Ureteral Stones: A Retrospective Cohort Study.
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Sun Dan, Song Yang, Xiong Jinzhou, Hu Ting
Аннотация
OBJECTIVE: To evaluate whether an evidence-based pain management and rehabilitation nursing pathway improves early recovery after mini-percutaneous nephrolithotomy (mini-PCNL) for complex renal or ureteral stones.
METHODS: This retrospective cohort study included 148 patients undergoing mini-PCNL from January 2023 to December 2025. The control group received routine perioperative nursing care (January 2023-June 2024), and the observation group received an evidence-based pain and rehabilitation nursing pathway (July 2024-December 2025), with 74 patients in each group. Stress indicators, pain, renal function, recovery milestones, and complications were compared.
RESULTS: Heart rate and mean arterial pressure changed over time, but did not differ between-group. Compared with the control group, the observation group had lower cortisol levels at 6 h (888.5 ± 159.3 vs 1074.1 ± 258.2 nmol/L) and 24 h postoperatively (522.7 ± 97.5 vs 868.0 ± 215.9 nmol/L), and lower adrenocorticotropic hormone levels at 6 h (20.7 ± 5.4 vs 26.9 ± 7.6 pmol/L) and 24 h postoperatively (12.6 ± 3.5 vs 21.4 ± 6.2 pmol/L). Median Visual Analogue Scale (VAS) pain scores were lower at 6, 12, and 24 h postoperatively (5, 4, 3 vs 7, 6, 5). At 24 h postoperatively, serum creatinine (87.5 ± 14.7 vs 96.4 ± 15.0 µmol/L) and blood urea nitrogen levels (5.59 ± 0.94 vs 6.36 ± 1.34 mmol/L) were lower. The observation group also had earlier first ambulation (13.3 vs 15.4 h), lower VAS scores at first voiding (3 vs 5), and shorter hospital stay (4 vs 6 days). Nephrostomy tube duration, catheter duration, urinary tract infection, and haematuria were similar.
CONCLUSIONS: Evidence-based pain management and rehabilitation nursing was associated with reduced early biochemical stress markers, improved pain control and short-term renal function, and accelerated early recovery after mini-PCNL.
METHODS: This retrospective cohort study included 148 patients undergoing mini-PCNL from January 2023 to December 2025. The control group received routine perioperative nursing care (January 2023-June 2024), and the observation group received an evidence-based pain and rehabilitation nursing pathway (July 2024-December 2025), with 74 patients in each group. Stress indicators, pain, renal function, recovery milestones, and complications were compared.
RESULTS: Heart rate and mean arterial pressure changed over time, but did not differ between-group. Compared with the control group, the observation group had lower cortisol levels at 6 h (888.5 ± 159.3 vs 1074.1 ± 258.2 nmol/L) and 24 h postoperatively (522.7 ± 97.5 vs 868.0 ± 215.9 nmol/L), and lower adrenocorticotropic hormone levels at 6 h (20.7 ± 5.4 vs 26.9 ± 7.6 pmol/L) and 24 h postoperatively (12.6 ± 3.5 vs 21.4 ± 6.2 pmol/L). Median Visual Analogue Scale (VAS) pain scores were lower at 6, 12, and 24 h postoperatively (5, 4, 3 vs 7, 6, 5). At 24 h postoperatively, serum creatinine (87.5 ± 14.7 vs 96.4 ± 15.0 µmol/L) and blood urea nitrogen levels (5.59 ± 0.94 vs 6.36 ± 1.34 mmol/L) were lower. The observation group also had earlier first ambulation (13.3 vs 15.4 h), lower VAS scores at first voiding (3 vs 5), and shorter hospital stay (4 vs 6 days). Nephrostomy tube duration, catheter duration, urinary tract infection, and haematuria were similar.
CONCLUSIONS: Evidence-based pain management and rehabilitation nursing was associated with reduced early biochemical stress markers, improved pain control and short-term renal function, and accelerated early recovery after mini-PCNL.